Towards Integrated Care for older home-dwelling adults with depression andmultimorbidity: Patients and caregivers’ perspectives from a qualitative study

Background The global population is rapidly aging, with the number of people aged ≥ 65 expected to more than double by 2050. This demographic shift is accompanied by a rise in multimorbidity, especially among older adults. Depression frequently co-occurs with chronic physical conditions in this group, creating a bidirectional relationship that exacerbates health outcomes, lowers quality of life, and increases care complexity. Integrated Care (IC) models have emerged as promising approaches to address these needs holistically. However, limited research explores how IC can effectively serve older adults with depression and physical multimorbidity, particularly from the perspectives of patients and informal caregivers (ICGs). Methods We conducted a qualitative study to explore the healthcare needs of older adults with depression and physical multimorbidity, along with their ICGs. We conducted semi-structured interviews with 10 patients and 5 ICGs, recruited from an ambulatory psychiatric setting. Data were analysed using inductive thematic analysis. Results Four key themes emerged: (1) Need for connection: participants emphasized the importance of familiarity, trust, and relational continuity with healthcare professionals; (2) Need for autonomy: patients valued shared decision-making and self-determination in treatment planning; (3) Importance of involving informal networks: family, friends, and neighbours provided essential practical and emotional support, often filling systemic care gaps; (4) System-level barriers to care: accessibility issues, poor care coordination, workforce shortages, caregiver burden, and psychiatric stigma were recurrent obstacles. ICGs, in particular, reported high emotional and logistical demands without sufficient recognition or support. Conclusion To address the complex needs of older adults with depression and physical multimorbidity, IC must integrate relational, emotional, and social dimensions of care. Patients and ICGs must be recognized as active partners, not peripheral participants, in care design and delivery. Our findings highlight the need for IC models that foster sustained connection, support patient autonomy, reduce fragmentation, and meaningfully involve caregivers. By centring patient and caregiver perspectives, future IC approaches can become more responsive, person-centred, and equitable.